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    <span style="font-family:宋体;">分期（延期）缴纳罚款申请书</span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">案由<span></span></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">处罚决定书文号<span></span></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">当事人<span></span></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">联系方式<span></span></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">违法事实<span></span></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">及处罚决定<span></span></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">当事人申请延期（分期）缴纳罚款的理由<span></span></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">&nbsp;&nbsp; </span><span style="font-size:12.0pt;line-height:150%;font-family:宋体;">当事人或其代理人签名：<span></span></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span style="font-size:12.0pt;line-height:150%;font-family:宋体;">时间：<span></span></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">执法人员<span></span></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">意见<span></span></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">执法员签名：<u><span>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></u>、<u><span>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></u><span></span></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span style="font-size:12.0pt;line-height:150%;font-family:宋体;">年<span>&nbsp;&nbsp; </span>月<span>&nbsp;&nbsp; </span>日<u><span></span></u></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">行政执法机关审批意见<span></span></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">负责人签名：<span>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span>
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                <span style="font-size:12.0pt;line-height:150%;font-family:宋体;">年<span>&nbsp;&nbsp; </span>月<span>&nbsp;&nbsp; </span>日<span></span></span>
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